Speechreading instruction for hard-of-hearing adults. Effects of training face-to-face and with a video programme

American Speech-Language-Hearing Association Clinical Practice Guideline on Aural Rehabilitation for Adults With Hearing Loss

BACKGROUND

Hearing loss poses a significant public health challenge as a common chronic condition with many known side effects that are often worse when left untreated. Aural rehabilitation (AR) is an umbrella term that encompasses a range of interventions (e.g., informational counseling and perceptual training) designed to reduce deficits related to hearing loss that may stand alone or be used in combination as part of a holistic plan.

PURPOSE

This evidence-based clinical practice guideline is intended to inform the implementation of person-centered AR to adults with hearing loss. Given the well-known benefits of sensory management, it was not included within the scope of this guideline. The recommendations aim to help clinicians, individuals with hearing loss, and other stakeholders make evidence-informed treatment decisions and improve clinical outcomes, as well as provide payers and policymakers with information detailing a comprehensive approach to AR.

METHOD

The American Speech-Language-Hearing Association (ASHA) and a multidisciplinary panel of subject matter experts prioritized key clinical questions and outcomes that served as the foundation of the guideline. The clinical recommendations were based on a comprehensive systematic review and a meta-analysis of 85 studies published between 1978 and 2021.

RECOMMENDATIONS

Given the current state of the evidence, resource considerations, patient acceptability, clinical feasibility, and the overall balance of benefits and harms, ASHA developed several evidence-based recommendations for the provision of AR to adults with hearing loss. Each recommendation is accompanied by a series of key practice points to support its implementation within a person-centered framework.

Speechreading in hearing children can be improved by training

Visual information conveyed by a speaking face aids speech perception. In addition, children’s ability to comprehend visual-only speech (speechreading ability) is related to phonological awareness and reading skills in both deaf and hearing children. We tested whether training speechreading would improve speechreading, phoneme blending, and reading ability in hearing children. Ninety-two hearing 4- to 5-year-old children were randomised into two groups: business-as-usual controls, and an intervention group, who completed three weeks of computerised speechreading training. The intervention group showed greater improvements in speechreading than the control group at post-test both immediately after training and 3 months later. This was the case for both trained and untrained words. There were no group effects on the phonological awareness or single-word reading tasks, although those with the lowest phoneme blending scores did show greater improvements in blending as a result of training. The improvement in speechreading in hearing children following brief training is encouraging. The results are also important in suggesting a hypothesis for future investigation: that a focus on visual speech information may contribute to phonological skills, not only in deaf children but also in hearing children who are at risk of reading difficulties. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=bBdpliGkbkY.

The effect of speech training experiences on speechreading skills of Chinese children with hearing impairment

Speechreading contributes significantly to effective communication, and persons with hearing impairment (HI) may need to rely more on speechreading. However, whether they may benefit from training/practice to improve their speechreading performance remains unclear. In this study, we examine the effect of speech training on speechreading performance of children with HI in China, and how such effect, if any, may be influenced by age. Fifty-nine HI children with speech training experiences, and fifty-eight HI children without speech training experiences completed tasks measuring their ability to speechread Chinese at the linguistic levels of words, phrases, and sentences. The children ranged from 7 to 14 years old, and were divided into four age groups by two-year age intervals. Both accuracy rate and response time data were collected. Results revealed three findings: (1) HI children with speech training experiences speechread more accurately but more slowly than those without speech training experiences; (2) while speechreading performance generally improved with age, age didn't alter the relative performance between the two groups; and (3) speechreading performance was best for phrases, and worst for sentences. These findings suggest that HI children benefit from speech training to improve their speechreading performance, and their speechreading performance is influenced by age, linguistic level, and the specific measure used.